Cancer Research Symposium

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Registration Form

1
Your Profile
2
Abstracts
3
Last Page
Part A. Your Profile
Provide your profile
Your Title *
Surname *
First Name *
Last Name
Email address *
Provide the email to be used to contact and communicate with you about the symposium
Phone number *
Provide your phone number starting with your country code
Nationality *
What is your highest level of education *
Enter the title of your highest qualification *
Are you currently an ongoing student? *
Enter the name of your institution *
Are you currently employed/engaged in cancer research programs? *
Enter the name of your institution (Optional)
Part B. Abstract Submission
This section is for those who would like to submit an abstract for presentation at the symposium
Would you like to submit an abstract for speaker/poster/workshop presentation? *
Select the type of presentation you wish to be considered for *
What is the title of your presentation? *
Please type out your abstract here *
Part C. Paying for your registration Fees
How to pay for registration fees

Please Note: After paying your registration fee, kindly email us the transaction details for verification on our end. You will recieve a confirmation email once verification is complete.   

All payments should be directed to the following account number below. You can pay either using a bank transfer, MPESA Paybill, or direct debit. Cash payments are not allowed. 

FOR BANK TRANSFER OR Direct debit, KINDLY USE THE DETAILS BELOW:

Account Name: INTEGRATED CANCER RESEARCH FOUNDATION OF KENYA

Bank: Kenya Commercial Bank

Branch: Moi Avenue, Kencom House Nairobi

Bank Account No:  1285887883 

SWIFT: KCBLKENX

FOR MPESA PAYMENT, KINDLY USE THE DETAILS BELOW:

Go To MPESA Paybill Option 

Enter KCB Paybill Number: 522522

Enter Account Details: 1285887883

Enter Amount: XXXXX

SUBMIT THE PAYMENT  

Your Data Privacy
What we do with your data

We use your data to communicate about the conference in accordance with the Data Protection Act 2019.

By submitting this form you agree to ICRF using your data for the purposes outlines above *
Your Signature *